Chronic Disease Management: Addressing Multiple Sclerosis in Alberta

The prevalence of chronic health conditions in Alberta is a pressing concern, affecting around 30% of the population, with this figure rising to over 75% among individuals aged 65 and above. As we approach 2031, the impending demographic shift is poised to intensify the strain on our healthcare system (Alberta Health Services, 2023), necessitating a more comprehensive approach to managing chronic diseases, including multiple sclerosis (MS).

MS involves an autoimmune response targeting the protective myelin sheath of nerves in the central nervous system (Public Health Agency of Canada, 2011). It is during the early stages of adulthood that individuals with MS often begin to experience the symptoms of physical, cognitive, and neurological impairments (Urits et al., 2019). MS patients suffering from central neuropathic pain, which is the severe and disabling pain associated with MS, often require treatment with opioids, NSAIDs, antiepileptics, and antidepressants, despite the limited efficacy and potential concerning side effects (Monteleone et al., 2018, as cited in Urits et al., 2019).

Based on the most recent data provided by the Canadian Chronic Disease Surveillance System (CCDSS) (n.d.), the average prevalence of MS across Canada in 2021 stood at 0.29%. Interestingly, during the same time frame, Alberta showed a higher MS prevalence rate of 0.33%. In 2022, 13,246 Albertans had MS, up from 12,938 in the previous year (Government of Alberta, n.d.).

The primary determinants of MS include geography, temperature, smoking, and genetics, all of which influence the risk of MS. Colder regions have higher rates of MS, while the protective potential of vitamin D and sunlight is currently under study. Smoking slightly increases the risk, and genetics play a significant role, with a 20-40% risk for identical twins and a 3-5% risk among siblings if one of them has MS (WebMD Editorial Contributors, 2023).

Living with MS requires continuous physical training. Experiencing a relapse is indescribable and can last for weeks. To maintain balance, patients need special fitness and balance training. Such treatments can improve the quality of life for MS patients (Roche, 2018).

The main modality for diagnosing MS is MRI with Gadolinium contrast injection. As with most diseases, early diagnosis and treatment will improve the quality of life for those patients. With many of treatment options, healthcare professionals must weigh pharmacological, non-pharmacological, and surgical interventions. Exercise and physical therapy might help decelerate the progression of the condition and lower the frequency of relapses (Urits et al., 2019).

References

Alberta Health Services. (2023). Chronic Disease Management. Alberta Health Services. https://www.albertahealthservices.ca/info/page11934.aspx

Government of Alberta. (n.d.). Interactive Health Data Application—Multiple Sclerosis. Retrieved November 5, 2023, from http://www.ahw.gov.ab.ca/IHDA_Retrieval/selectSubCategoryParameters.do

Government of Canada. (n.d.). Canadian Chronic Disease Surveillance System (CCDSS). Retrieved November 5, 2023, from https://health-infobase.canada.ca/ccdss/data-tool/index?G=00&V=19

Public Health Agency of Canada. (2011, March 23). Multiple Sclerosis [Organizational descriptions]. https://www.canada.ca/en/public-health/services/chronic-diseases/multiple-sclerosis.html

Roche. (2018, January 12). Living with multiple sclerosis | Felix’s story. [Video]. YouTube. https://www.youtube.com/watch?v=_aa2hKL0A_o

Urits, I., Adamian, L., Fiocchi, J., Hoyt, D., Ernst, C., Kaye, A. D., & Viswanath, O. (2019). Advances in the Understanding and Management of Chronic Pain in Multiple Sclerosis: A Comprehensive Review. 23(8). https://doi.org/10.1007/s11916-019-0800-2

WebMD Editorial Contributors. (2023). The Different Types of Multiple Sclerosis (MS) Explained. WebMD. https://www.webmd.com/multiple-sclerosis/multiple-sclerosis-understanding-the-differences-in-ms